Request for PSA

This form is intended to initiate a Professional Service Agreement (PSA) with an independent contractor, to be paid for by a federally sponsored project, for services that cost more than $2,000.00.

The information entered into this form will be sent to the Office of Sponsored Programs, and will be vetted against the funding source that is provided. Some situations may require an internal rebudget, and/or sponsor approval, in which case OSP will contact you outside of this form.

In order for WPI to issue payment, any and all consultants must be added to Workday as a “Supplier”. No consultant will receive payment from a PSA prior to being a verified “Supplier” in Workday.

WPI uses Docusign to circulate the PSA for review and signature. You do not need a Docusign account in order to sign. When providing email addresses below, please make sure they are regularly monitored.

If you have any questions about this form (i.e. is it necessary, how to fill it out, what happens after you submit, etc.), please contact Chelsea D’Urso (cedurso@wpi.edu).

PROJECT INFORMATION

PI Name: *

PI Department: *

E-mail: *

Phone *

Project Title: *

Sponsor: *

Grant Worktag: *

CONSULTANT COMPENSATION DETAILS

Total Payment Not to Exceed Amount: *

If your total payment does not exceed $2000, you do NOT need to fill out this form.

Please download and fill out the Vendor Selection form and upload below when finished.

Vendor Selection Form: *

How will the consultant be paid? *

Hourly/Daily

Fixed Installments

Hourly/Daily Rate: *

Fixed Amount of $XX in XX Installments: *

CONSULTANT INFORMATION

Name (person and/or company): *

E-mail: *

Phone Number: *

Full Mailing Address: *

STATEMENT OF WORK

Description of Services Provided, Including Any Deliverable Schedule(100 character min): *

0 characters

Currently, what country are you physically present in? *

*

By providing the information requested in this form, you are consenting to WPI’s use of the provided information for the purpose for which the form is being used. See Privacy Policy Below.